Do No Harm: Stories of Life, Death, and Brain Surgery, Henry Marsh, 2014
This is a wonderful book in which Marsh, a 60-something year old neurosurgeon, the senior consultant at one of Britain’s flagship specialty hospitals, shares memories, anecdotes, and observations about his 30+ years in medicine. In 25 brief chapters, each one titled with the name of a neurosurgical disease, Marsh recapitulates his career as a young house officer, houseman, junior registrar, and finally senior consultant and the patients whom he has been privileged to care for. Stories of success and failure, of cure and post-op disability and death, of individual patients whom he clearly remembers and dozens who have faded from memory are told with humor, sympathy, empathy, insight, and humility. I loved the clinical details and the physician observations (e.g. the biggest worry for doctors is ‘uncertainty’), but I’m not sure how a non-physician would view them. My only quibble with this fine book is that Marsh maintains too much of a doctorly distance for me. I yearned to know him better. He mentions that his infant son developed acute hydrocephalus secondary to a brain tumor that was successfully treated but he makes no connection between that life-altering event and his own decision to enter neurosurgery (and, what is even more strange, he never mentions his son again after this story in the shortest chapter in the book). We hear nothing about the end of his first marriage or what led to his second. Finally, the book ends rather abruptly with a funny exchange with a return visit patient about her in-hospital stool chart. I would have had Marsh provide a final epilogue, a summary of the abundant wisdom derived from experience over 3 decades of cutting into and manipulating the 3 pound mass of tissue(2% of body weight, 25% of cardiac output) that allows us to see, think, plan, mourn, and relate. Nevertheless, a superb book.